A Comparative Study between Rectus Sheath Block and Quadratus Lumborum Block for Post-Operative Analgesia Following Para-Umbilical Hernia Repair Surgery

Abstract

Abstract Background Umbilical hernia repair, is a common day-surgery procedure and associated with considerable postoperative discomfort. The goal of postoperative pain management is provision of comfort, early mobilization and improved respiratory function without causing inadequate sedation and respiratory compromise, which can be achieved through using multimodal analgesic therapy, preference for regional techniques, avoidance of sedatives, non-invasive ventilation with supplemental oxygen and early mobilization. Aim of the Work To assess the analgesic efficacy of ultrasound-guided trans-muscular quadratus lumborum block compared with rectus sheath block during para-umbilical hernia repair surgery and in the early postoperative period by measuring and comparing postoperative VAS score and first time to rescue analgesia and the total amount of opioid (pethidine) given in the first 24 hours. Patients and Methods Patients undergoing paraumbilical hernia repair will be randomly assigned into one of the following groups using computer generated codes and opaque sealed envelopes: Group 1 (QL group) will receive bilateral ultrasound guided QLB. Group 2 (RSB group) will receive bilateral ultrasound guided RSB. Results The two groups were adequately monitored and assessed post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system, besides, recording time for first call for rescue analgesia. Demographic data, post-operative hemodynamics, and sedation score were also assessed. Conclusion Quadratus lumborum block was more effective technique in providing analgesia after para-umbilical hernia repair surgery in comparison to rectus sheath block and even more time covering to rescue opioid.